Plaque buildup isn't anything most people think about, but we should. It can start developing during childhood and progress rapidly causing major health issues. "Plaque is made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin" John Hopkins Medicine says. "As it builds up in the arteries, the artery walls become thickened and stiff."
Arteries are blood vessels that carry blood throughout your entire body and when arteries are unhealthy, clogs start to happen, which means blood can't flow where it needs to. As a result, heart disease can occur and oftentimes there's no symptoms until something serious like a heart attack takes place. The Centers for Disease Control and Prevention states, "Coronary artery disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which can partially or totally block the blood flow. This process is called atherosclerosis."
Heart disease remains the leading cause of death even though many cases are preventable. The CDC says, "Coronary heart disease is the most common type of heart disease, killing 382,820 people in 2020. About 20.1 million adults age 20 and older have CAD (about 7.2%). In 2020, about 2 in 10 deaths from CAD happen in adults less than 65 years old. Eat This, Not That! Health spoke with cardiologists who explained what to know about CAD and when to get help. As always please consult your physician for medical advice.
What to Know About CAD?
Eric Stahl, MD, Non-Invasive Cardiologist at Staten Island University Hospital tells us, "Coronary artery disease (CAD) is often caused by atherosclerosis, which is the process by which fatty plaque builds up in the walls of the arteries. Atherosclerosis starts in the second and third decade of life as a result of high cholesterol, smoking, high blood pressure, diabetes, obesity, lack of exercise, poor diet or family history. It can progress over years, until significant blockages develop. Myocardial infarction or heart attack occurs with severe blockage."
Dr. Jeffrey Tyler, MD – Interventional Cardiologist – Providence St. Joseph Hospital, Orange County, Calif says, "The arteries that give the heart muscle oxygen are called the coronary arteries. They are called the coronary arteries because they encircle the heart like a crown. Coronary originates from the Latin "coronary" and Greek "koron" which mean crown. These arteries become narrowed when cholesterol and fat get deposited in the walls of these vessels. Coronary artery disease leads to heart attacks and heart failure We see early plaque in people beginning as early in their 20s."
CAD is Common Even Though It's Preventable
Dr. Stahl states, "Approximately 20.1 million Americans have CAD. Many of the risk factors for CAD or atherosclerosis are preventable, but remain highly prevalent in the USA. Regular screening and aggressive risk factor modification is needed to prevent the progression of CAD."
According to Dr. Tyler, "CAD remains extremely common because many of our lifestyle choices and diets predispose us to developing it. Cigarette smoking remains one of the most important causes of developing CAD. A diet low in fruit and vegetables significantly raises the risk of CAD as does a diet with a high glycemic load (White bread, Orange Juice, Soda, etc) or red meat. High blood pressure and high cholesterol are two leading causes of CAD that often go hand in hand with poor diet and exercise. Finally, many people have a strong family history of CAD and this often has to do with genes that predispose us to CAD."
When to Seek Medical Attention and Signs to Watch Out For
Dr. Tyler says, "Many people with coronary artery disease do not feel any different in the beginning. As the plaque severity progresses, people often experience chest discomfort in the center of the chest that may also travel to the arms, back, jaw or stomach. These often get worse with exercise or emotional stress and better with rest. If someone develops chest discomfort, shortness of breath, heartburn, sweating, racing heart rate or feeling like they are faint and this lasts for more than 5 minutes or comes and goes, they should seek medical attention immediately by calling 911."
Dr. Stahl explains, "Unfortunately, a heart attack is the first presentation of CAD for many people. Others may develop angina, which can be a sign of significant blockage. Patients who experience angina often describe having chest pain, chest discomfort, or shortness of breath, especially with exertion. If you experience these symptoms, you should seek medical attention. Before developing symptoms, it is important to undergo screening for risk factors for CAD. Everyone over the age of 20 should undergo screening with routine examination and blood work at least every 5 years."
CAD Can Be Different for Women
According to Dr. Stahl, "CAD is the leading cause of death for both men and women in the USA. However, there are some differences between genders. Although traditional risk factors effect both genders, women are also at increased risk of CAD due to pregnancy complications, menopause, and oral contraceptives. Studies have shown that women with CAD are often older than men with CAD. A delay in diagnosis can occur because women with CAD are more likely to have either no symptoms or atypical symptoms, such as dull pain, indigestion, fatigue, or nausea. Women are also more likely to have alternative etiologies of CAD, such as microvascular disease, coronary artery spasm, or spontaneous coronary artery dissection."
Dr. Tyler states, "CAD is the most common cause of death in women in the US, exceeding that of cancer and other causes. Many women still develop chest discomfort however many also feel other symptoms that are often incorrectly disregarded as anxiety or non-cardiac causes such as shortness of breath, weakness or fatigue."
CAD Can Be Treatable
Dr. Tyler says, "While CAD can be life threatening, it is very treatable using changes in lifestyle, diet, exercise and medicines. Occasionally we recommend people get surgery or stents placed for critical blockages. Fortunately our medications and lifestyle interventions have become extremely effective."
Dr. Stahl adds, "The most effective way to treat CAD is to treat the risk factors that cause it. Reducing cholesterol, quitting smoking, controlling blood pressure, treating diabetes, exercising and improving diet are all important to treat and reverse CAD. If these methods are insufficient, medications such as statins should be used to lower cholesterol, slow the growth of atherosclerotic plaque, and in some cases reverse the amount of plaque. If severe blockage develops, patients can be evaluated for a procedure to open the blocked arteries with stents."
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